Abbo O, Bouali O, Beauval J-B, Moscovici J, Galinier P
Service de chirurgie viscérale pédiatrique, hôpital des enfants de Toulouse, CHU de Toulouse, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 9, France.
Prog Urol. 2012 Mar;22(3):192-4. doi: 10.1016/j.purol.2011.10.003. Epub 2011 Nov 29.
Surgically relevant obstruction after dextranomer/hyaluronic acid injection (Dx/Ha, Deflux(®)) for the treatment of vesicoureteral reflux (VUR) is rare with a 0.6% incidence. It occurs usually during the early postoperative period. We report here the case of a 9-year-old boy with a history of VUR who was previously treated with Deflux(®) and was referred more than 2 years later with acute flank pain (as he already did 2 weeks after surgery with a spontaneous relief under medical treatment). Initial radiological investigations showed hydronephrosis caused by distal ureteral obstruction which required open surgery removal of the Dx/Ha and Cohen procedure. This is the second case of delayed symptomatic obstruction due to Dx/Ha reported in the literature.
在使用葡聚糖凝胶/透明质酸注射剂（Dx/Ha，Deflux®）治疗膀胱输尿管反流（VUR）后发生的与手术相关的梗阻较为罕见，发生率为0.6%。它通常发生在术后早期。我们在此报告一例9岁男孩，有VUR病史，此前接受过Deflux®治疗，2年多后因急性腰痛前来就诊（术后2周他也曾因腰痛前来，经药物治疗后自行缓解）。最初的影像学检查显示由输尿管远端梗阻导致的肾积水，这需要通过开放手术取出Dx/Ha并进行科恩手术。这是文献中报道的第二例因Dx/Ha导致的延迟性症状性梗阻病例。
